FORM - XXVI





DECLARATION AS REQUIRED UNDER SECTION 6A(6) OF THE CITIZENSHIP ACT, 1955 TO BE FILLED IN BY THE PERSON WHO DOES NOT WISH TO BECOME A CITIZEN OF INDIA



[Rule 16G]



(TO BE FILLED IN TRIPLICATE)



DECLARATION



I………………………… (son /daughter of) …………………………………………….

(………………………)

(wife of ……………………….)

resident of………………………………… (Full name and address) hereby solemnly declare that I do not wish to become a citizen of Indian to be governed by sub-sections (4) and (5) of the section 6A of the Citizenship Act, 1955.

Date:

(……………………………………….)

Place::

Signature or thumb impression of the applicant

TO BE FILLED IN THE OFFICE OR REGISTERING AUTHORITY

Registration No……………… (Registration number is to be given after registering the foreigner under the Foreigners Act, 1946).

SEAL

Date: (……………………………………….)

Place::

Signature of the registering authority